NPIMap

Organization Active NPI

Liberty Spine and Pain LLC

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1851657886
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0400479905 Issued in NJ
Legal business name
LIBERTY SPINE AND PAIN LLC
Practice address
263 W End Ave Apt 22B
New York, NY 10023-2617
Phone
(214) 615-5168
Fax
(888) 526-9542
NPI assigned
Apr 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Nick Lloyd
Title
VP of Athas
Phone
(214) 615-5168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 0400479905 NJ Primary

Addresses

Primary practice location

263 W End Ave Apt 22B
New York, NY 10023-2617

Mailing address

PO Box 3837
Carol Stream, IL 60132-3837
Phone (214) 615-5168

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1851657886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3837",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601323837",
            "telephone_number": "214-615-5168",
            "fax_number": "888-526-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 W END AVE APT 22B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232617",
            "telephone_number": "214-615-5168",
            "fax_number": "888-526-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY SPINE AND PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-03",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "LLOYD",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "VP OF ATHAS",
        "authorized_official_telephone_number": "214-615-5168",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "0400479905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.